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Rev Endocr Metab Disord. 2017 Sep;18(3):335-346. doi: 10.1007/s11154-016-9405-9.

Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept.

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Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy.
Ios and Coleman Medicina Futura Medical Center, University Federico II, Naples, Italy.
Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.
Emergency Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Comando Brigata Alpina Julia/Multinational Land Force, Medical Service, Udine, Italy.
TSEM med Swiss SA, Lugano, Switzerland.
Department of Urology, Bolognini Hospital, Seriate, Italy.
Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy.
Laboratory of Clinical Pathology, San Antonio Hospital, Tolmezzo, Italy.
Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, Germany.
Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy.


In the last few years, more attention has been given to the "non-calcemic" effect of vitamin D. Several observational studies and meta-analyses demonstrated an association between circulating levels of vitamin D and outcome of many common diseases, including endocrine diseases, chronic diseases, cancer progression, and autoimmune diseases. In particular, cells of the immune system (B cells, T cells, and antigen presenting cells), due to the expression of 1α-hydroxylase (CYP27B1), are able to synthesize the active metabolite of vitamin D, which shows immunomodulatory properties. Moreover, the expression of the vitamin D receptor (VDR) in these cells suggests a local action of vitamin D in the immune response. These findings are supported by the correlation between the polymorphisms of the VDR or the CYP27B1 gene and the pathogenesis of several autoimmune diseases. Currently, the optimal plasma 25-hydroxyvitamin D concentration that is necessary to prevent or treat autoimmune diseases is still under debate. However, experimental studies in humans have suggested beneficial effects of vitamin D supplementation in reducing the severity of disease activity. In this review, we summarize the evidence regarding the role of vitamin D in the pathogenesis of autoimmune endocrine diseases, including type 1 diabetes mellitus, Addison's disease, Hashimoto's thyroiditis, Graves' disease and autoimmune polyendocrine syndromes. Furthermore, we discuss the supplementation with vitamin D to prevent or treat autoimmune diseases.


Addison’s disease; Autoimmune polyendocrine syndromes; Autoimmunity; Environment; Graves’ disease; Hashimoto’s thyroiditis; Lifestyle; Type 1 diabetes mellitus; Vitamin D

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